Sunday, January 24, 2010

At this stage, the U.S. House (last November) and Senate (last December) have each passed their own (different) health care reform bills. Normally, the two bodies would reach a unified compromise bill via a conference committee, and then pass the conference bill through each chamber and on to the President's desk. The win by Republican Scott Brown in last Tuesday's special U.S. Senate election in Massachusetts knocks the Democrats back down to 59 seats in the Senate, however, thus depriving them of the 60 votes needed to shut down a Republican filibuster (which a conference bill would certainly have drawn).

One possible way to salvage a bill along the lines of what's already been passed is for the House to pass the Senate-approved bill exactly as is. Because both bodies would then have passed the same exact legislation, it could go to the President without a conference process. Many House liberals apparently don't want to vote for the Senate-passed bill, though, feeling that it doesn't accomplish enough. Apparently as a result, Speaker Pelosi has said the votes aren't there in the House for the Senate bill.

Another option would be for the Senate to pass some additional provisions -- which many House liberals would like -- through budget reconciliation. Reconciliation requires only 51 votes to pass the Senate, but can only be applied to budget-relevant provisions (i.e., something that's a pure policy change with no relation to government spending cannot go through reconciliation). Nate Silver refers to potential changes through reconciliation to adjust the December-passed Senate bill as the "Senate sidecar." The House could then pass a new bill (or bills) that encompasses both the December-passed Senate bill and the Senate sidecar. Still other liberals appear to favor "blowing up" the already-passed House and Senate bills, having the Senate pass new bills through reconciliation, and having the House pass corresponding bills.

The aforementioned Nate Silver has attempted to make sense of the situation. He has a neat chart displaying a long list of specific health care provisions, how much popular support each enjoys (based on this month's Kaiser poll), whether the provision is already in the December-passed Senate bill, and Nate's guess as to whether the provision could be passed through reconciliation (due to budget relevance).

Tuesday, January 12, 2010

At this stage, with the U.S. House and Senate each having passed its respective version of health care reform in late 2009, we're waiting to see what kind of merged, compromise bill emerges so the House and Senate can vote on final passage. We're also waiting on a January 19 special U.S. Senate election in Massachusetts to fill the late Ted Kennedy's seat, which will determine whether the Democrats still have 60 seats (including two Independents who caucus with the Democrats) to ward off Republican filibusters.

With the House-passed public option seemingly dead due to Senate resistance and relatively few major issues still being negotiated between the two chambers, most of the current polling appears to be on general preferences.

Gallup, which for several months has been asking respondents if they would advise their members of Congress to vote for or against health care reform, now (Jan. 8-10) shows "for" edging ahead of "against," 49 to 46 percent, the first time the "for" side has led since last October.

A more pessimistic tone comes from a new CBS poll (Jan. 6-10), however, as "Just 36 percent of Americans approve of Mr. Obama's handling of health care... In December of last year, 42 percent of Americans approved of the president’s handling of health care, and 47 percent approved in October."

The CBS poll asked its questions in a way that, in my view, provides greater context than most polls about what seems to be going on. First, the poll asked about three main objectives of reform: expanding health-insurance coverage, cost-control, and regulation of the insurance industry. Second, the poll asked respondents whether they felt congressional proposals went too far, got it about right, or did not go far enough, with regard to each of the three aforementioned objectives.

Questions that ask respondents if they think health care reform in general does or doesn't go too far are open to multiple interpretations. To liberals, "not going far enough" could mean not expanding coverage to enough people, whereas to conservatives it could mean not doing enough to roll back government involvement in health care. By asking respondents whether they think the current legislative proposals go too far or not far enough, specifically and separately with regard to coverage, cost-control, and regulation, CBS appears to have removed much of the ambiguity in interpreting the results.

On the question, "Do you think the changes to the health care system under consideration in Congress go too far in trying to provide health insurance to as many Americans as possible, don't go far enough, or are the changes about right?," the 35% saying not far enough would seem to be responding in a liberal direction, with another 22% saying about right (detailed results).

On the question, "Do you think the changes to the health care system under consideration in Congress go too far in trying to control costs, don't go far enough, or are the changes about right?," 39% say not far enough. I'd argue there is some ambiguity here, as liberals could be referring to cost control by reining in the industry whereas conservatives might mean cutting government spending.

The third question -- "Do you think the changes to the health care system under consideration in Congress go too far in trying to regulate the health insurance industry, don't go far enough, or are the changes about right?" -- seems to go a long way in clarifying things. Here, a "not far enough" response would seem to be liberal. Indeed, self-identified Democrats (50%) were more likely to say the plan didn't go far enough than Republicans (26%); Independents said not enough at a 48% rate. For the total sample, 43% said the plan didn't go far enough.

Introduction

Professor Alan Reifman of Texas Tech University, who teaches social science research methodology, compiled and commented on health care-reform public opinion polls as Congressional debate heated up in the late summer and fall of 2009, and legislation was enacted in the spring of 2010. He continues to chime in periodically regarding new developments in the health care saga.

Followers

R2K Polling Controversy

On June 29, 2010, the website Daily Kos announced that polls it had commissioned from the firm Research 2000 were "likely bunk." Kos has asked readers to disregard all R2K polls done for his site. Any Kos/R2K polls cited here on the Health Care Polls blog over the past several months should accordingly be disregarded, as well. I am leaving them up, however, as part of the historical record. Often, my analyses of polling trends that included R2K surveys also included polls from other firms, too. I hope the pending lawsuits between Kos and R2K will reveal whether the latter's polls are completely valid, completely made-up, or perhaps, as Nate Silver suggested, the product of data being merely "mangled."